An Observation and Analysis of a Specific Potential Manning Weakness

If you watch him closely, you can’t help but see that Peyton Manning is having difficulties with his throws. There are specific patterns that I have noticed watching and reviewing his play since the preseason. His passes to the right half of the field are, for the most part, weak and/or inaccurate. These observations have been consistent and predictable. Why predictable? If you followed my posts last year, you will remember that I explained that C7, the nerve involved in the disc problem that led to his surgeries, innervates the triceps muscle. This is the muscle which accounts for the extension of his elbow in the throwing motion. But what other muscle is innervated by C7?..........The major portion of the pectoralis major muscle. Why is this important? The pectoralis major muscle is one of the strongest muscles in the body. And it gives POWER to the throwing motion.

Go through the motion of pretending that you are throwing a football straight forward, while feeling your pectoralis. You will feel it contract as it strongly assists the upper arm moving forward and inward towards the chest. When you then throw across your chest to the left you will be able to obtain maximum force to the throw in that you receive maximum contribution from the pectoralis. When a throw is made to the right, the pectoralis contributes little to the power of the throw.

If you watched Manning last game, it was painfully obvious that any successful passes to the right were short and low. And in some of those, in order to compensate, he turned his whole body to his target so that it would be more equivalent to a straight ahead throw (using the assist of the pectoralis). All three of his interceptions came when he attempted intermediate passes to the right side of the field while facing the middle of the field. Those passes and others floated and/or were inaccurate. Remember, accuracy especially with longer passes require adequate power. Power or the lack thereof affects accuracy. The less power behind your throw, the less likely a longer throw will be delivered accurately and the more likely you will lose form and inappropriately overuse the core muscles in desperate attempt for additional forward power. This last game, Peyton’s greatest success was with throws across his body to the left side of the field as in the case of his sole TD pass.

[As an aside, C7 also innervates the latissimus dorsi muscle which can to a much lesser degree contribute to a forward pass.]

Keeping all of this in mind, a defense strategy that could serve Wade well would be to place maximum pass rush pressure to Peytons right and force him to the left of his back field. This way it would significantly lessen his chances of going to the right side with his passes and encourage him to focus mostly on the left side of the field. At the same time, Wade could concentrate his secondary’s attention to the left awaiting those passes. If Peyton chooses to still throw from his exaggerated left backfield position to the right side of the field, his throws would be that much weaker and more inaccurate, making them less likely to be completed and ripe for the pick. Forcing Peyton to pass to his right could be the Texans' path this Sunday to driving him to his Waterloo.

Cloak, is Manning's arm strength something that will improve over time?

Not sure if this has been discussed on the board already, but a friend told me he'd heard a doctor on the radio saying that Manning's still not 100% but his arm strength should be much better by the end of the season.

Cloak, is Manning's arm strength something that will improve over time?

Not sure if this has been discussed on the board already, but a friend told me he'd heard a doctor on the radio saying that Manning's still not 100% but his arm strength should be much better by the end of the season.

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Thank you, TF.

Dr. First on 610 was the one that was asked this question and gave that answer. Surprisingly, he made no further characterization or comments.

Nerve regeneration is a very unpredictable process. The rule of thumb is that by 2 years from the time of injury or repair, you will usually have attained your final return results. The longer between the time of injury to the relief of compression, the more atrophy of the target muscles and the more dubious the complete-to-previous condition regeneration. What needs to be kept in mind is that Manning's nerve root problems (compression) date back for years, with only temporizing incomplete "fixes" along the way before his definitive surgery. His last surgery was just over a year ago. How much irreversible permanent damage was done to the nerve and muscles by the time he finally had his last surgery, no one can truly quantify. But no doubt there has been some. You can develop muscle by exercising. But there has to be good innervation to send continuous signal to the muscle for that development. And there is very little that can reliably or predictably facilitate the regeneration of a nerve. He may improve some through the season. Or he may not improve beyond what he is today. But, applying my pretty extensive experiences in treating traumatic nerve injuries to what I know about his history and with what I see now, I find it very unlikely that he gets all that much closer to what he used to be. Though only time will tell.

Dr. First on 610 was the one that was asked this question and gave that answer. Surprisingly, he made no further characterization or comments.

Nerve regeneration is a very unpredictable process. The rule of thumb is that by 2 years from the time of injury or repair, you will usually have attained your final return results. The longer between the time of injury to the relief of compression, the more atrophy of the target muscles and the more dubious the complete-to-previous condition regeneration. What needs to be kept in mind is that Manning's nerve root problems (compression) date back for years, with only temporizing incomplete "fixes" along the way before his definitive surgery. His last surgery was just over a year ago. How much irreversible permanent damage was done to the nerve and muscles by the time he finally had his last surgery, no one can truly quantify. But no doubt there has been some. You can develop muscle by exercising. But there has to be good innervation to send continuous signal to the muscle for that development. And there is very little that can reliably or predictably facilitate the regeneration of a nerve. He may improve some through the season. Or he may not improve beyond what he is today. But, applying my pretty extensive experiences in treating traumatic nerve injuries to what I know about his history and with what I see now, I find it very unlikely that he gets all that much closer to what he used to be. Though only time will tell.

I'd put KJ on the side of the field where Manning's throws are weakest. I'd put Joseph to the left where Manning has his best success. KJ could have a career game off that strategy.

Crash the left side of the line and force Manning to roll to his right. Make sure we're covering the shallow escape route stuff in the middle of the field, the little curl routes and such that McGahee and Tamme will run (to bail out Manning).

Someone somewhere mentioned in camp, I think it was Mort from ESPN, that Manning couldn't throw to his right very well. CND's analysis confirms it.

Even in the preseason game I watched, I could see that his throws to the right were taking forever to get there. Stuff to the left had mustard on it.

Now let's see if Wade will capitalize on it or think he doesn't have to strategize for it. I hope he does. I hope they're benching Manning by the half.

Dr. First on 610 was the one that was asked this question and gave that answer. Surprisingly, he made no further characterization or comments.

Nerve regeneration is a very unpredictable process. The rule of thumb is that by 2 years from the time of injury or repair, you will usually have attained your final return results. The longer between the time of injury to the relief of compression, the more atrophy of the target muscles and the more dubious the complete-to-previous condition regeneration. What needs to be kept in mind is that Manning's nerve root problems (compression) date back for years, with only temporizing incomplete "fixes" along the way before his definitive surgery. His last surgery was just over a year ago. How much irreversible permanent damage was done to the nerve and muscles by the time he finally had his last surgery, no one can truly quantify. But no doubt there has been some. You can develop muscle by exercising. But there has to be good innervation to send continuous signal to the muscle for that development. And there is very little that can reliably or predictably facilitate the regeneration of a nerve. He may improve some through the season. Or he may not improve beyond what he is today. But, applying my pretty extensive experiences in treating traumatic nerve injuries to what I know about his history and with what I see now, I find it very unlikely that he gets all that much closer to what he used to be. Though only time will tell.

I wish I could answer your question more definitively.

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Wait... what?
Doesn't that mean Peyton has been operating at less than 100% during this time?? Soooo if he's had this issue for years, then he's used to functioning at less than 100%, right.

Wait... what?
Doesn't that mean Peyton has been operating at less than 100% during this time?? Soooo if he's had this issue for years, then he's used to functioning at less than 100%, right.

Worry meter just went up a notch.

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I may be reading wrong here, but doc may be referring to the way Manning refused treatment from anyone but his trusted Colts medical staff in the 11 offseason, of course due to the lockout he wasn't able to see them and as such allowed his condition to worsen over the offseason before getting it treated.

I may be reading wrong here, but doc may be referring to the way Manning refused treatment from anyone but his trusted Colts medical staff in the 11 offseason, of course due to the lockout he wasn't able to see them and as such allowed his condition to worsen over the offseason before getting it treated.

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Not so fast.

A cervical disc typically will present mostly as pain. As we all know pain alone can be compensated for quite well. Sensory changes can then accompany the pain, but can lag until more chronic interval of nerve compression. After a period of time, pain is greeted with the beginnings of nerve atrophy and muscle weakness/dysfunction. In years passed, Peyton delayed his definitive surgery by opting for minimally invasive procedures that probably helped some with the compression of his nerve, and thus alleviated pain and sensory problems. However, it is most likely that during the previous offseason is when he first noticed a significant weakening and dysfunction. I doubt seriously that having had access to his therapist, i.e., nonsurgical therapy in general, was at that point going to be a key to a turn about. This would be confirmed by the fact that even the 2011 offseason/preseason minimally invasive surgeries were not enough to correct the compression and his functional problems. Thus, before this preseason, I dare say, we would not have seen a truly "debilitated" Peyton.

One thing I've noticed about PM is his decreased head rotation, not as quick, and his tnedency to keep his head lowered. Seems like he keeps his chin tilted down toward his chest more than usual. Don't think it's my imagination either. Pain maybe? Adhesions? Maybe psychological?

I'd put KJ on the side of the field where Manning's throws are weakest. I'd put Joseph to the left where Manning has his best success. KJ could have a career game off that strategy.

Crash the left side of the line and force Manning to roll to his right. Make sure we're covering the shallow escape route stuff in the middle of the field, the little curl routes and such that McGahee and Tamme will run (to bail out Manning).

Someone somewhere mentioned in camp, I think it was Mort from ESPN, that Manning couldn't throw to his right very well. CND's analysis confirms it.

Even in the preseason game I watched, I could see that his throws to the right were taking forever to get there. Stuff to the left had mustard on it.

Now let's see if Wade will capitalize on it or think he doesn't have to strategize for it. I hope he does. I hope they're benching Manning by the half.

One thing I've noticed about PM is his decreased head rotation, not as quick, and his tnedency to keep his head lowered. Seems like he keeps his chin tilted down toward his chest more than usual. Don't think it's my imagination either. Pain maybe? Adhesions? Maybe psychological?

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Patients who have had a fusion, even single level, do not achieve the same range of motion as people without cervical spine problems. The rule of thumb is that for every level of fusion, you may expect ~10% decrease in range of motion. The number of vertebrae fused together determines the amount of motion they may be missing compared to normal values. Since much of the motion in the neck (flexion, extension, rotation, lateral flexion) mostly occurs in the upper cervical spine, a person with only one or even two fusions in the mid or lower cervical spine typically will not have any noticeable deficits without actually measuring with a goniometer.

With that said, he seems to me to have possibly clinically lost some right head rotation. However, this could also be due to continued pain when turning to that side. He may be trying to avoid full extent of motion to that side because it still induces pain with that motion. If he is seen to keep his chin down, I would have to also chalk it up more to this same reason (protective splinting), and not to an anatomic basis.

Patients who have had a fusion, even single level, do not achieve the same range of motion as people without cervical spine problems. The rule of thumb is that for every level of fusion, you may expect ~10% decrease in range of motion. The number of vertebrae fused together determines the amount of motion they may be missing compared to normal values. Since much of the motion in the neck (flexion, extension, rotation, lateral flexion) mostly occurs in the upper cervical spine, a person with only one or even two fusions in the mid or lower cervical spine typically will not have any noticeable deficits without actually measuring with a goniometer.

With that said, he seems to me to have possibly clinically lost some right head rotation. However, this could also be due to continued pain when turning to that side. He may be trying to avoid full extent of motion to that side because it still induces pain with that motion. If he is seen to keep his chin down, I would have to also chalk it up more to this same reason (protective splinting), and not to an anatomic basis.

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You must not post much in the NSZ, doc. Didn't anyone tell you that the phrase "rule of thumb" is insulting to women these days?

Crash the left side of the line and force Manning to roll to his right. Make sure we're covering the shallow escape route stuff in the middle of the field, the little curl routes and such that McGahee and Tamme will run (to bail out Manning).

As I stated before, if he is weak to his right, the rush (crash) should come from his right, forcing him to his left. Doing so, minimizes territory that he can more effectively throw into, i.e., the area into which he can throw straight ahead or across his body to the left. The narrower we can make that left side of the field, the wider that right side of the field becomes and the greater is his difficulty to complete the pass.

If the rush comes from the left, he may roll out to his right, allowing him, if he chooses, to run with his body for the most part facing the right-most side of the field, thus making his throws as though he is still throwing motion forward or across his body, despite that it is to the right side of the field. It essentially makes most of the field available to throw into, his relative left, which you wouldn’t want to do. With that said, during the last game, during heavy rush, he didn’t show great legs to effectively break out into a roll out either. It seemed rather that he showed preference to his fetal position.

While this, as usual, is great info from doc...Manning still has the best mind of a QB that has ever played in the NFL. I think he's learning what his limitations are with every snap he takes. The best thing going for us at this point is that we're playing them in week 3.

Years ago I cut my wrist while helping a friend with a remodel down in Galvatraz, severing 8 tendons, both arteries and 2 nerves. Needless to say, me and my right forearm were very happy a hand specialist happened to be on call that weekend. He saved my arm from having to be removed (wife even had to sign the paper to give them authority).
Anywho, the nerves never came all the way back. I have a good 75% of feel back, but hardly any motor skills at all (can't spread fingers out, hold small items, etc).

All that said, I learned what I could and could not do and adjusted. I can write again with it, throw a ball, lift weights, shake hands, etc.

He'll learn and he'll adjust as we began seeing in the 2nd half. He'll get his points. Will we?